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by ristoalas 2253 days ago
Unfortunately, the answer seems "no" so far. Based on for example [1], the infection fatality ratio appears to be 10 times worse than the seasonal flu for people aged 30-39. Also, hospitalisation rate is higher (e.g. in age group 30-39, the study estimates that 3.4% of the infected people were hospitalised), which is higher (even for younger people) than the hospitalisation rate of the flu.

[1] https://www.thelancet.com/action/showPdf?pii=S1473-3099%2820...

1 comments

Without disputing that (and thx for link), it's worth noting that the "flu" has been killing a large number of people year in and year out for as long as we can remember.

The long-term death rate of COVID-19 remains to be seen. The final verdict on how bad it was will depend on whether or not lengthy immunity is attained (including to mutations).

Yeah, but I don't understand what is significance of that claim. We have flu vaccine and general push to make people vaccinate every year. Up to mandating it for hospital workers at some places. Some employers are organizing them for free for employees.

We do close schools here and there for a week or so when flu is getting large to get it under control. We do close hospitals for visits at this times.

One implication is that COVID-19 might not be "just the flu". It might actually end up being far less damaging than the flu, as viewed over decades. And we don't trash our economy and the lives of the working class that depend on it due to flu deaths, even though they are still quite dramatic.

Personally, I'm conservative on this, and have barely left my place in the last eight weeks. I can work from home and will suffer little even if the lockdown is quite lengthy. But not everyone is in such a fortunate position, and I think we need to consider what's happening very carefully.

New York state has had 1 person in 1,200 [0] die from COVID-19, and is on track for 1 in 1,000. Do you know 1,000 people? If you lived in NYC, how many of your acquaintances would have died? How many people you know die from the flu every year?

Not even the most extreme estimates I've seen suggest that NY has anything approaching 50% immunity. Reopening NY and letting people catch CV19 would double, triple, ? the death rate.

There is no suggestion that NY is special as regards total numbers. (Velocity, due to population density, assume yes.) This is not the flu.

[0] A of 2020-04-17 880 deaths per 1M population. http://91-divoc.com/pages/covid-visualization/

FWIW, I don't know 1,000 people. Of the people I know about, one person has (probably) had COVID-19 (mild), and it's possible that I had it early (also mild).

Aside from "old age", the leading causes of death (and certainly years lost) among people I knew are AIDS and traffic collisions. This virus is going to have to try a lot harder to get on that scoreboard.

It's also worth noting that "reopening" doesn't mean people will just revert to prior behavior. Most will be very careful, and some will never revert. Wuhan reopened, and their restaurants are not springing back (yet?).

NYC is absolutely not representative of the rest of the country. In fact, they appear to be the hardest hit locale in the world in no small part due to their poor and delayed response.

I agree, reopening NYC would be a mistake, but large portions of the US (especially rural areas) remain largely unaffected by this.

The average age of death in my state (MN) is 88 with preexisting conditions. Our death rate is 0.0019% (!) with a flattened curve for some time now. Most of the US is not NYC.

The point being, an unusually large percentage of the people who contract CV19 die. Lower density == longer time to hit X% infected and Y% dead, but you'll still get there. (With caveats that X is a bit lower with lockdown, and Y gets higher when medical system is overloaded.)

Minnesota death rate is, as you say, currently at 19/million, but is growing at about 10%/day. The curve fits WA state's; continuing along that curve, WA currently has 79/million and is growing by 3%/day.

Honestly, I see the worry that we are overreacting. But you are way more likely to end up in the hospital with covid with rates of around 10-15%. Super broad strokes, if you get the flu every year and are at least 20 years old, what is the probability you would have be hospitalized if covid=flu?

I think we are considering things carefully. I can’t remember the last time you saw both dem and rep governors agree on anything, yet they are all agreeing on stay at home orders and testing.

Until there are large scale accurate antibody tests, it will be hard to say if the hospitalization rate for covid is that high or not.
By "viewed over decades" we count in period when vaccine is supposed to exist, when we have cheaper tests and know to put on masks when something happens and when majority of population has antibodies. Even the most pessimistic estimates expect the issue to be dealt with in decades.

Also, the thing to consider is that working class is whonis most at risk from this. Rich people have less comorbidities, can afford healthcare and are much more easily to work from home and buy via deliveries.

This is basically reason why African Americans die the most - working class can't isolate themselves so easily. They are the group to die more then same age non working class.

> it's worth noting that the "flu" has been killing a large number of people year in and year out for as long as we can remember.

> The long-term death rate of COVID-19 remains to be seen.

At the moment we count flu deaths differently to covid-19 deaths.

Counting deaths due to flu is hard. We've only just started this work for Covid-19 by putting in standards for death certification. These stats lag the real time counts by some time, and they're always higher than the real time counts.

So, we're taking a method for counting flu than over-counts, and a method for covid-19 that undercounts, and then saying "covid-19 isn't that bad".

And that's just looking at deaths. We also need to look at hospitalisation (because we want to look at all the harm caused by different illness to assess whether our measures are reasonable or not; and because iatrogenic harm is a thing) and we see that covid-19 does put a lot more people in hospital than flu normally does. And this difference is only partly explained by rates of immunisation against flu.

Well in England&Wales the National Statistics Office figures show <500 deaths (I think that excludes specific flus, H1N1 and such, which would add 4 more; ) for the most recent figures (2017 IIRC), for a ~60M population. Papers I've seen suggest a adults get flu every 5 years, children ~every 3 years. So we're looking roughly at rates of 500 per 15M. 1:30000.

Now there's some controversy that UK government have been reporting other deaths as flu, basically hiding Winter deaths due, eg to poor elderly care, in flu figures. So other sources suggest far far higher flu rates; but this is going off death registrations.

https://www.ons.gov.uk/peoplepopulationandcommunity/birthsde...

Covid19 death rates for under 50s are something of the order 1:1000, 30x the flu rate in data I've seen most recent (Worldometer) but reported rates vary considerably.

That doesn't sound right. If fewer than 500 per year were dying of flu, we probably wouldn't even bother with flu shots.
That's after flu shots, in the year where flu shots were a misfire (they guessed the wrong strains) there were 2000 additional deaths (according to another source I'm not confident in that claims to have ONS figures but which I've not been able to confirm); for comparison the reported deaths (ie hospital only) for UK [which includes Scotland] has passed 15000 for Covid19 according to https://www.worldometers.info/coronavirus/#countries [fwiw I wrote 10,000 as that was the figure last time I looked ... but then checked the current number ...].

Happy for you to show it if this is wrong.

That seems very low. In the US, about 25,000 to 60,000 die annually of flu with about 5x the population of England and Wales.
Yes, we should do more about the flu.
Arguably we should. For that matter, we should really do more about traffic fatalities. Bringing that down would be far easier per person than fixing flu or coronavirus.

We're not going to, though, and it's becoming less clear why COVID-19 is an exception. It reminds me some of 9/11--it's flashy and freaking everyone out, which leads to irrationally conservative behavior.

It's because it is a much bigger immediate problem. Look at the Mortality Surveillance section on https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidvi...

That's with lock downs.

It's also hard to say what individual behavior would look like absent government orders to close businesses. Retail business could well be way down without any orders.

I think the original US lockdowns should have happened far sooner and been far more stringent. In my ultra-liberal state, the governor decided just within the last week or two that schools should definitely be closed until July. Idiot.

But, as we pass the initial peak and have better experience and surveillance, we should very carefully consider what to do next. Just locking down for a year or two is not the "safe" option.